SVPAM Patient Centered Medical Home Survey 

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100% of survey complete.
Thank you for participating in our patient survey.
Your participation is voluntary.  You may choose to answer this survey or not.  If you choose not to, this will not affect the health care you receive in any way.  

Please know that your privacy is protected.  Your responses to this survey are completely confidential and unidentifiable unless you choose to share your contact information with us at the end of the survey.  We are proud to identify our practice as a Pediatric Patient Centered Medical Home (PCMH) and will use all responses gathered to enhance the quality of our services and your experience in our office each time you visit or interact with us.  Thank you for being part of our medical home!

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* 1. Which office is your child most often seen in ?

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* 2. Which provider does your child most often see when you come in for routine, well-child care?

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* 3. How long has your child been a patient with SVPAM?

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* 4. In the last 12 months, how many times did your child visit SVPAM for care?

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* 5. Is your child able to talk with providers about his or her health care?

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* 6. In the last 12 months, how often did the provider explain things in a way that was easy for you and your child to understand?

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* 7. In the last 12 months, how often did the provider listen carefully to you and your child?

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* 8. Did the provider give you enough information about what you needed to do to follow-up on your child's care?

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* 9. In the last 12 months, how often did you get an appointment as soon as your child needed?

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* 10. In the last 12 months, when you phoned our office during regular office hours, how often did you get an answer to your medical question that same day?

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* 11. In the last 12 months, if you phoned our office AFTER regular office hours, how often did you get an answer to your medical question as soon as you needed it?

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* 12. Wait time includes time spent in the waiting room and exam room.  In the last 12 months, was your wait time to start the visit process with the nurse:

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* 13.  In the last 12 months, after seeing the nurse, was your wait time in the EXAM ROOM:

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* 14. In the last 12 months, how often did the provider seem to know the important information about your child's medical history?

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* 15. In the last 12 months, how often did your healthcare provider show respect for what you had to say?

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* 16. In the last 12 months, was your child ordered a blood test, x-ray or other test?  If yes, how often did someone from the office follow up to give you those results?

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* 17. Using any number from 0 to 10, where 0 is the worst provider possible and 10 is the best provider possible, what number would you use to rate your healthcare provider?

  10 Best provider possible 9 8 7 6 5 4 3 2 1 0 Worst provider possible
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* 18. In the last 12 months, did anyone in our office ask you if there are things that make it hard for you to take care of your child's health?

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* 19. In the last 12 months, how often were the receptionists & nurses at our office as helpful as you thought they should be?

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* 20. What is your child's age?

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* 21. If you have additional concerns, please contact our Chief Operating Officer, Liz Yankello, at 724-417-9254.

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* 22. Date completed:

Date

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* 23. Do you have any other comments, questions, or concerns?

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Thank you for your time from all of us at SVPAM.  We are honored to participate in your child's healthcare.

Thank you for your time from all of us at SVPAM.  We are honored to participate in your child's healthcare.

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